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PMT15-03092 City of Menifee Permit No.: PMT15-03092 29714 HAUN RD. Type: Residential Addition 4ACCELJ MENIFEE,CA 92586 MENIFEE Date Issued: 12/30/2015 PERMIT Site Address: 25893 BETH DR, MENIFEE,CA 92584 Parcel Number: 358-232-016 Construction Cost: $112,312.05 Existing Use: 1 &2 Family Residence Proposed Use: Description of 2ND UNIT 997 SQ FT Work: Owner Contractor BRAD SIMPSON ASPEN CONSTRUCTION ENTERPRISES INC 25893 BETH DR P O BOX 129 MENIFEE,CA 92584 WILDOMAR,CA 92595 Applicant Phone:9516966114 MIKE JOHNSON License Number:932234 ASPEN CONSTRUCTION ENTERPRISES INC PO BOX129 WILDOMAR, CA 92595 Fee Description aty Amount(Ei Services, Switchboards, Control Centers&Panels 1 116.00 Receptacle, Switch, Outlet&Fixture 65 436.00 Plumbing Fixtures and Vents,fixtures 8 141.00 Gas System 1 116.00 Piping/Repiping Single Family Residential 1 163.00 Plan Check Fee 103 102.50 Plan Check Fee 103 102.50 Residential Water Heater 1 83.00 Sewer 1 150.00 Forced-Air or Gravity-Type Furnace or Burner 1 149.00 Air Handling/Condensing Units SFR 1 133.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 578 577.50 Additional Plan Review Building 45 45.00 GREEN FEE 1 5.00 SMIP RESIDENTIAL 1 15.00 New Construction Permit Fee 1 507.83 General Plan Maintenance Fee-Plumbing 1 32.65 General Plan Maintenance Fee-Electrical 1 27.60 General Plan Maintenance Fee-New 1 25.39 Construction $2,954.97 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bidg_Permit Template.rpt Page 1 of 2 City Of Menifee LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for the I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence in Professions Code a d m1yr license is in full force and effect. which I must have resided for at least one year prior to completion of License Class t:S License No. 3 y improvements covered by this permit, I cannot legally sell a structure that I have Expires y-36—ZO/7 Stgnaturd' l built as an owner-building if It has not been constructed in Its entirety by licensed contractors. I understand that a copy of the applicable law. Section 7044 of the WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is submitted or at the following Web site: will❑ I hereby m under penalty of perjury one of the following declarations: http:/Aw .leginfo.ca.aov/calaw.html. I have and will maintain a certificate of consent of self-insure for workers' compensation,issued by the Director of Industrial Relations as provided for by Dale Section 3700 of the Labor Code, for the performance of work for which this permit is issued. Property Owner or Authorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the property P!' I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to building �� G` construction.I authodze representatives of this city or county to enter the above- Carrierr, l above- Carrier /_46 G identified property for the inspection purposes. Policy# %/,?03e Expires Ll^ t'S 'ZOI Date Property Owner orAuthorized Agent (This section need not be completed If the permit is for City Business License# one-hundred dollars($100)or less) ❑ 1 certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not emolov any persons in any manner so as to became subject to the WIII the applicant or future building occupant handle hazardous material or a workers'compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the subject to the workers'compe sation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide? Code,I shall forthwith id fth those provisions. 7 ❑YES ENO • Applicant; Date; <G'.�6 ^ /_ Will the intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNING: AILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES ),NO CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD 1 hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous material reporting OWNER BUILDER DECLARATIONS DYES AN I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWN R RAUTHORIZED AGENT next to the applicable item(s)(Section 7031.5.Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP) or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors provisions of the Contractor's State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1978 Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit ❑ www.epa.gov/lead or contact the National Lead Information Center at 1, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323). compensation,will do( )all of or( )porting of the work,and the structure is not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name: the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the Firm Certification No.: purpose of sale). ❑ 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because: contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of a property who builds or improves thereon, and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP & SAFETY •ERM IT/PLAN CHECK APPLICATION - _ Menifee DATE 0'5- /S PERMIT/PLAN CHECK NUMBER pMTiS-o3o�a TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME C POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O11 PLUMBING O RE--ROOF-NUMBER OF SQUARES 1 DESCRIPTION OF WORK In-cd V1 er PROJECTADDRESS �j 3e'+ �� Ib f ASSESSOR'S PARCEL NUMBER �J �' 23Z" O�b ' �0 LOT TRACT %30 OWNER NAME R('Ct lo ADDRESS rZS893 8 -�h Or PHONE 31 O - CI foH- "738(a EMAIL APPLICANT NAME t ✓I y O v1 - A S�r ,nPAil ADDRESS QSO L-"5 e?) eI` Id, "V- PHONE J S1- Z IS-1 I 1 L EMAIL to co �0 �ry �o 0 CONTRACTOR'SNAM/�E ,45 y `/�o6j_sjrJLr, �^If INC OWNER BUILDER? OYES ONO BUSINESS NAME A5 .t y1 �C00 ruJ {o c'n4rr IS - ttt++ k^ c_ ,p ADDRESS P, O •, Q o 1Z �1 4 o Y» r ! 2 S oj,5 PHONE qs/- EMAIL ct 5pen ca ns�vock,o `al- cav % CONTRACTOR'S STATE LIICC NUMBER 13 22 3Y LICENSE CLASSIFICATION g VALUATION$ 1 IE�:T I�•ro SO.FT 3,k O L SQ FT a S(c ckvcc APPLICANT'S SIGNATURE,-,-;?O�� A S)kDATE /h-^ S- � - DEPARTMENT DISTRIBUTION l� CITY OF MENIFEEEBBU CENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE �]'�. PAID AMOUNT / 1 AMOUNT 16so. a J CASH CHECK# %CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT <; CASH CCHCCK# :%CREDIT CARD VISA/MC OWNER BUILDER VERIFIED C YES O NO OIL NUMBER NOTARIZED LETTER C YES C NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 G o.'TM f CITY OF MENIFEE t �AENIFE�," Planning Department N. . .. APPLICATION FOR CONCURREN PROk SSING This is an application to request that the r nslruction plans concurrently with the Planning Department's processing of the related development application- Please complete the required information and sign the waiver and assumption of risk, and return the completed application to the Planning Department. INCOMPLETE APPLICATIONS IMLL NOT BE ACCEPTED PLANNING APPLICATION NO: _a2O15-1 iS DATE SUBMITTED: —�— APPLICATION INFORMATION Applicant's Name: A'Spe-n C�h51 / vct 1� 1 E-Mail: p�h �c�r.5�rvuc� whop l�c,�ma<<t p Mailing Address: P, d , !'0 V, 12 `j i GIDV1q ' 'Street 0 fy\ L R Q city State ZIP Daytime Phone No: ( 4S( ) 215 19 z Fax No: ( ) As applicant for the above-referenced project, I/We hereby request that the Wublic Works Department accept construction plans for review concurrent with the Planning Department's processing of the applicable development applications. As applicant for the above referenced project, I/We acknowledge that acceptance of plans by the Department of Public Works for review prior to final action on the proposed project does not explicitly or implicitly suggest that the project will receive final approval. I/We assume the full risk that the plans submitted at this time may not ultimately conform to the approved project or any changes necessitated by the final conditions of approval, or that the subject proposed project may ultimately be denied. I/We recognize that any fees submitted to the Department of Public Works for the processing of plans may be nonrefundable if this project is ultimately denied, or if subsequent project redesign or the final conditions of approval result in the requirement for changes in the plans, and that additional fees may be required by the Department of Public Works for the processing of plans required due to project redesign. I/We further acknowledge that acceptance of construction plans and the payment of fees to the Department of Public Works does NOT obligate the Planning Department to support a proposed ro'ect design. --2d A e �� ro o-h PRINTEDNAME OFAPPLICANT SIGNATURE A LICANT 29714 Haun Road Menifee, Califomia 92586 (951)672.6777 , Fax (951)679-3843 FOrM 295-1015(04./0911 2) Page 1 of 2 APPLICATION FOR CONCURRENT PROCESSING DATE: TO: FROM: PLANNING DEPARTMENT RE: REQUEST FOR CONCURRENT PROCESSING PLANNING APPLICATION NO. The applicant for the above referenced case has requested that the Department of Public Works accept construction plans concurrent with the filing of the above referenced planning case. The Planning Department has no objection to the acceptance of such plans by the Department of Public Works pending a final decision on the subject planning application. Concurrent review does not explicitly or implicitly suggest that the specific project design has been found acceptable at this time. The applicant assumes the full risk that a project redesign, approved conditions of approval, or denial of the project may make the construction plans unacceptable or moot, and that any or all of the fees for the processing of the plans may be nonrefundable. Acceptance of construction plans and the payment of fees to the Department of Public Works does NOT obligate the Planning Department to support or approve a proposed project design. ADDITIONALLY, NO PERMITS SHALL BE ISSUED BY THE DEPARTMENT OF PUBLIC WORKS PRIOR TO AN APPROVAL OF THE ABOVE REFERENCED DEVELOPMENT PROPOSAL, AND ISSUANCE OF THE FINAL CONDITIONS OF APPROVAL BY THE PLANNING DEPARTMENT. CITY OF MENIFEE PLANNING DEPARTMENT G� As applicant for the above referenced project, I/We acknowledge that acceptance of plans by the Department of Public Works for review prior to final action on the project proposal does not explicitly or implicitly suggest that this project will receive final approval. I I We assume the full risk that the plans submitted at this time may not ultimately conform to the approved project or any changes necessitated by the final conditions of approval, or that the subject proposal may ultimately be denied. I/We recognize that any fees submitted to the Department of Public Works for the processing of plans may be nonrefundable if this project is ultimately denied or if subsequent project redesign or the final conditions of approval result in the requirement for changes in the plans, and that additional fees may be required for the processing of plans due to project redesign. I/We further acknowledge that acceptance of construction plans and the payment of fees to the Department of Public Works does NOT obligate the Planning Department to support or approve a proposed project design. SalIr,6,S 'Zr PRINTED NAME OF APPLICANT LI-GNA-TURKOe APPLICANT Form 295.1015(04/09/12) Page 2 of 2